What do employees on long-term sick leave experience, as barriers for returning to work?

Abstract Background The financial burden long-term sick leave places on society are immense and amounted to an annual cost of 180 billion NOK in Norway. Epidemiological and sociodemographic risk factors related to sickness absence and return to work (RTW) are well studied, less is known regarding self-perceived biopsychosocial barriers for RTW. The aim of this study was to investigate the diversity of barriers for RTW as experienced by long term sick listed employees. Methods The study is a large-scale qualitative interview study (n = 85), using semi-structured telephone interviews. Participants were eligible to participate if they had received sick leave benefits >6 months and <1,5 years at the time of recruitment, for at least 50% of their employed work hours. The data was analysed with a directed qualitative content analysis combined with a summative approach. A deductive approach, guided by the theoretical framework provided in Model of Human Occupation (MoHO) were used in the analysis process. In MoHO, the main categories are person specific components and environmental components. Results The study generated 952 coded meaning units describing barriers for RTW. Of these, we were able to deductively code 917 within the framework of MoHO. In the person specific concept, performance capacity barriers were dominant (n = 530). Volitional barriers (n = 164) were related to personal causation, hereunder self-efficacy (n = 24), and one's sense of capacity (n = 91). Barriers related to habituation (n = 64) was expressed as habits, both necessary habits and undesirable habits. Barriers related to the environmental component amounted to 388. The majority was linked to occupational environment (n = 217), including availability of adequate work tasks and barriers related to the healthcare system. Conclusions The experienced RTW-barriers extended beyond health-related barriers, for most of the participants the barriers were related to both person specific components and environmental components. Key messages • By gaining a greater understanding of the experienced RTW-barriers we could possibly provide more tailored RTW-services and help sick listed to a safe and sustainable return to work. • The experienced RTW barriers for long term sick listed were primarily related to person specific and environmental components, and thus extended beyond health-related barriers.


Background:
The financial burden long-term sick leave places on society are immense and amounted to an annual cost of 180 billion NOK in Norway. Epidemiological and sociodemographic risk factors related to sickness absence and return to work (RTW) are well studied, less is known regarding self-perceived biopsychosocial barriers for RTW. The aim of this study was to investigate the diversity of barriers for RTW as experienced by long term sick listed employees.

Methods:
The study is a large-scale qualitative interview study (n = 85), using semi-structured telephone interviews. Participants were eligible to participate if they had received sick leave benefits >6 months and <1,5 years at the time of recruitment, for at least 50% of their employed work hours. The data was analysed with a directed qualitative content analysis combined with a summative approach. A deductive approach, guided by the theoretical framework provided in Model of Human Occupation (MoHO) were used in the analysis process. In MoHO, the main categories are person specific components and environmental components.

Results:
The study generated 952 coded meaning units describing barriers for RTW. Of these, we were able to deductively code 917 within the framework of MoHO. In the person specific concept, performance capacity barriers were dominant (n = 530). Volitional barriers (n = 164) were related to personal causation, hereunder self-efficacy (n = 24), and one's sense of capacity (n = 91). Barriers related to habituation (n = 64) was expressed as habits, both necessary habits and undesirable habits. Barriers related to the environmental component amounted to 388. The majority was linked to occupational environment (n = 217), including availability of adequate work tasks and barriers related to the healthcare system.

Conclusions:
The experienced RTW-barriers extended beyond health-related barriers, for most of the participants the barriers were related to both person specific components and environmental components.

Key messages:
By gaining a greater understanding of the experienced RTWbarriers we could possibly provide more tailored RTWservices and help sick listed to a safe and sustainable return to work. The experienced RTW barriers for long term sick listed were primarily related to person specific and environmental components, and thus extended beyond health-related barriers.

5.K. Workshop: National and European studies on health literacy in children and adolescents
Health literacy describes how people use health information to make informed decisions in context of healthcare, disease prevention and health promotion. Enhancing health literacy of populations is critical and in particular important at an early age, which is understood to be more sustainable because health literacy contributes to improved personal health and development. Low health literacy in child and adolescent populations has been linked to worse health outcomes and health disparities in Europe, making health literacy of children and adolescents an important public health topic. Developing and delivering target group specific interventions and services requires precise data generation on the state of health literacy in early age. In the past decade, several conceptual approaches have been undertaken but methodological sound, validated and reliable measurement tools are still scarce. Available systematic reviews show that most tools originated from North America and/or English speaking countries. However, in the past years European researchers have been involved with research on health literacy in childhood and adolescence, the result of which culminated into heavy progress regarding the development of health literacy measurement instruments, including generic health literacy, digital health and mental health literacy. These new developments lead to the availability of validated tools for school-aged children, including primary and secondary school children. The purpose of this workshop is to bring together five contemporary health literacy studies conducted in child and adolescent populations across Europe, including national and European-wide studies. Both methodological findings regarding the measurement tool and